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General NPI Number Information
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NPI Number | 1164345435
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Entity Type | Organization
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Legal Business Name | TRANQUIL MINDS, NURSE PRACTITIONER IN PSYCHIATRY, PLLC
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Dates
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Enumeration Date | 08/03/2026
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Last Update Date | 08/03/2026
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Provider Practice Location Address
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Address Line | 455 RIDGE RD
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City | HARTSDALE
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State | NY
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Zip | 10530-2224
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Country | US
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Telephone | 949-769-4481
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Fax | 914-341-3979
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Provider Business Mailing Address
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Address Line | 455 RIDGE RD
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City | HARTSDALE
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State | NY
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Zip | 10530-2224
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Country | US
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Telephone | 949-769-4481
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Fax | 914-341-3979
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Authorized Official
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Title or Position | OWNER
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Name | KELLY CONKLIN CONKLIN
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Credential | NP
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Telephone | 949-769-4481
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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